Study: Safety net programs don’t support high rates of trauma in participants

New research by the Center for Hunger-Free Communities at Drexel University shows that participants in a federal assistance program for families living in poverty have overwhelmingly high levels of adversity and exposure to violence that can limit their success in the workplace. In spite of that, employment is a requirement to qualify for many of these programs.

Providing monetary assistance to those living in poverty, the Temporary Assistance for Needy Families (TANF) program requires each family's head of household to work at least 20 hours per week unless they are exempt. But the Center's study — which looked at Philadelphia families with children under the age of six who are participating in TANF — made it clear that such safety net programs need to take the difficulties of poverty into account.

The research team from Drexel found that an extremely high number of participants witnessed or have been subject to violence, and roughly a third had an adverse childhood experience (such as abuse or neglect). Additionally, nearly half of the fathers of the participants' youngest child spent time in prison.

"Programs like TANF require participants to overcome overwhelming stress without proper support. Participants face adversity in their childhoods that cause lifelong mental health challenges and can be barriers to success, "said Mariana Chilton, PhD, MPH, director of the Center for Hunger-Free Communities and professor in Drexel's Dornsife School of Public Health. "By acknowledging exposure to trauma and toxic stress and by building in peer support into TANF, programs like our Building Wealth and Health Network can better prepare families for the workforce and help them to break out of poverty."

Families who were part of the Center's study were participants in the Building Wealth and Health Network, a demonstration project out of the Center for Hunger-Free Communities that began in 2014. The Network offers trauma-informed peer support groups and financial empowerment classes. As part of the class, the participants open savings accounts and –through grant funding — the Center matches their deposits.

According to the study's data, of the 103 participants (94 percent of whom were women), 65 percent had seen someone who was seriously wounded by violence and 27 percent saw someone being killed. On top of that, 60 percent said they'd been slapped, punched or hit, 30 percent said they'd been beaten up or mugged and over 17 percent said they'd been attacked or stabbed with a knife.

When it came to adverse experiences from their childhood, 43 percent of the participants in the study reported substance abuse by a household member, 37 percent reported emotional abuse and 18 percent had been sexually abused.

Almost 60 percent of the participants reported depression and just over half said they felt their food situation was threatened or unsecure.

All of these numbers were significantly higher than a representative sample of the population of Philadelphia.

The study, which was published in BMC Public Health, was led by Chilton and co-authored by Seth Welles, PHD, ScD, a professor in the Dornsife School of Public Health. Jing Sun, a now-graduated doctoral student in the Dornsife School of Public Health, analyzed the data and was the first author on the paper.

Although their findings indicate that those on TANF face many challenges when trying to gain steady employment, the study team found that, on a scale established to measure employment hope, most participants were rated at the high end. In fact, a little more than 20 percent had the top score. On a scale for self-efficacy, the participants again ranked relatively high, slightly exceeding the national average.

"These results prove that people receiving TANF benefits are highly motivated and confident in their career readiness, but face many obstacles in achieving their goals," said Falguni Patel, research manager of the Building Wealth and Health Network. "Our public assistance programs need to improve those programs so more people can be successful."

With so many challenges faced by young families in poverty, safety net programs like TANF need to integrate programs and services that address trauma. The research shows that TANF participants want to work but need access to programs that address financial and psychological adversity, like the Building Wealth and Health Network, to ensure potential success in the workforce.

"Our research shows that the adversities faced by families in poverty can be overcome. Through a trauma-informed approach, families can gain the skills and support they need in order to break the cycle of poverty," said Patel. "Our goal is to see these findings inform TANF and other programs so they are more focused on the needs and therefore success of the participants."